programs that have failed because of poor educational and communication components.
Integration of social, behavioral, and communication components in water services interventions. Phyllis Nsiah-Kumi of Northwestern University noted that at the beginning of any intervention is the need to understand the community’s knowledge, attitudes, and beliefs about the problem in question. The incorporation of these factors needs to be used as the central foundation, so that the water field can teach the community about available solutions and why these solutions are important to health.
A water-centered focus. Diane Dupont of Brock University noted that if the research interest is in water and water services, then water needs to be in the center diagram. From there, the field needs to develop the linkages from water to all of the different aspects that might relate to it. This change in focus may address the unintended consequences that can prevent the project from being a success. Thus, before the start of the project, it is important to think about what the ramifications may be.
During the workshop, a number of individuals alluded to the need for evaluation, and the panel explored best practices or effective matrices for measuring success. Dupont started with the idea that assessment of previous experience is the creation of a knowledge base on sustainable water services. Once the knowledge base is created, anyone can access it, and it is hard to recover the costs of maintaining it. What is needed is an agency or an organization to act as a central clearinghouse, where information is readily available for researchers to use. However, without a strong evaluation program, the knowledge base is incomplete, subject to bias, and exists only with the researchers in the field.
Paul Hunter of the University of East Anglia noted that one of the problems with evaluation is determining the appropriate objectives. A number of nongovernmental organizations use targets, such as the number of wells sunk. However, whether or not those wells are effective, are poisoned with arsenic, or improve the health of the population are more difficult matrixes to evaluate. It is not only the providers, but also many of the funders, who do not adequately think through the evaluations. Hunter noted that, even major institutions such as at the World Bank, can give the impression that they are more concerned with whether or not funds are dispersed than with whether projects achieve worthwhile outcomes, such as meeting health goals. Therefore, there needs to be more discussion, when money is given, to very clearly define the objectives about what needs to be done, and what the health aims are. Hunter stressed that money should be given out with the proviso that the intervention achieved its goals, not just that the work has been done.
Richard Gelting of the Centers for Disease Control and Prevention expanded